Provider Demographics
NPI:1093451098
Name:MOBILE FOOT CARE LLC
Entity Type:Organization
Organization Name:MOBILE FOOT CARE LLC
Other - Org Name:ALL INCLUSIVE WOUND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-214-5387
Mailing Address - Street 1:20 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1064
Mailing Address - Country:US
Mailing Address - Phone:860-214-5387
Mailing Address - Fax:
Practice Address - Street 1:20 RIVER RD
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:CT
Practice Address - Zip Code:06085-1064
Practice Address - Country:US
Practice Address - Phone:860-214-5387
Practice Address - Fax:860-507-7551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty